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Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD patients. Additional factors that can worsen well-being include dialysis treatment, malnutrition, inflammation, and lack of social support. The aim of our study was to analyze the quality of life of CKD patients undergoing hemodialysis and its association with certain biochemical and immunonutritional parameters, as well as with social support. Materials and Methods: This research was conducted as a cross-sectional study that included 170 patients, divided into two groups: a group of patients undergoing hemodialysis (HD group) (n = 85), and a control group of non-hemodialysis patients (group with CKD stage 3–4) (n = 85). The Health-Related Quality of Life (HRQoL) score was used to assess the quality of life of the study population. Measurement of biochemical and immunonutritional parameters was also performed in all patients. The Oslo-3 Social Support Scale (OSSS-3) was used to analyze social support. Results: The HRQoL score was significantly lower in HD patients compared to patients with CKD stage 3–4 (0.701 ± 0.137 vs. 0.832 ± 0.122, p < 0.001). It declined significantly as the concentrations of urea (β = −0.347, p < 0.001), creatinine (β = −0.699, p = 0.005), uric acid (β = −0.184, p = 0.016), β2-microglobulin (β = −0.432, p < 0.001), and parathormone (β = −0.209, p = 0.006) increased in HD patients. In addition to uremic toxins, an increase in glucose (β = −0.278, p = 0.010) and triglyceride (β = −0.354, p = 0.001) concentrations was associated with poor HRQoL in patients with CKD stage 3–4. There was a significant connection between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and HRQoL in HD patients (β = 0.229, p = 0.035). Additionally, C-reactive protein (β = −0.361, p < 0.001) and neutrophil-to-lymphocyte ratio (β = −0.288, p < 0.001), as markers of systemic inflammation, directly affected HRQoL in HD patients. In both study groups, perceived social support positively influenced the HRQoL scores (β = 0.192, p = 0.012 for hemodialysis; β = 0.225, p = 0.038 for non-hemodialysis). Conclusions: There is a decline in HRQoL in chronic hemodialysis patients, significantly affected by certain biochemical and immunonutritional parameters, along with perceived social support.

Background/Objectives: Health literacy represents the ability to access, understand, appraise, and apply health information for making appropriate health decisions. It is closely linked to education, income, employment, and overall health outcomes. Limited health literacy is associated with poor self-care, inadequate treatment adherence, and increased healthcare utilization. This study aimed to assess the level of health and medication adherence behaviors among primary health care users in Montenegro and examine its association with key demographic and socioeconomic factors. Methods: A cross-sectional, multicenter study was conducted among 202 primary health care users at the Primary Healthcare Center Danilovgrad, Plav and Ulcinj, Montenegro. Data were collected using a demographic questionnaire, the standardized European Health Literacy Questionnaire (HLS-EU-Q-47), and the Attitudes towards Medication Adherence Self-Reported Questionnaire (ADHERE-7). Statistical analyses included descriptive statistics, χ2 tests, and univariate and multivariate regression. Results: The mean HLS-EU-Q Index was 33.55 ± 8.05. Significant differences in literacy levels were observed by age (p = 0.022), material status (p = 0.043), and self-rated health (p = 0.020). In multivariate ordinal regression analysis, lower income (<400 €) was associated with lower odds of belonging to a higher health literacy category (OR = 0.22, 95% CI: 0.02–0.92, p = 0.039), while no statistically significant associations were observed for gender, education level, or employment status after adjustment. The mean ADHERE-7 score of the study population was 21.78 ± 5.19. When analyzed in relation to the level of health literacy, the highest mean ADHERE-7 score was observed among participants with excellent health literacy (24.28 ± 4.90). Lower levels of health literacy were associated with lower odds of belonging to higher health literacy categories among participants reporting selected non-adherence behaviors, including missing therapy 3–4 times per week (OR = 0.30), frequently skipping prescribed medication when feeling well (OR = 0.03), and reducing or omitting therapy due to perceived lack of benefit or high costs (OR range: 0.10–0.31). Conclusions: Health literacy among primary care users in Montenegro is moderate, with a substantial proportion exhibiting limited literacy. Low income is a key determinant of limited literacy, and limited health literacy was associated with poorer medication adherence. Targeted educational and policy interventions are needed to improve health literacy and reduce health inequalities.

PurposeThe main purpose of this study was to analyze the characteristics of dyspepsia and contributing factors in Montenegrin maintenance hemodialysis patients.MethodsThe study included 43 patients undergoing hemodialysis with symptoms of dyspepsia and 40 control dyspeptic subjects with preserved kidney function. All subjects underwent an interview about dyspeptic symptoms, physical and biochemical examination, and upper gastrointestinal endoscopy with pathohistological analysis of biopsy specimens.ResultsEarly satiety, bloating and heartburn were the most common symptoms in hemodialysis patients but without significant difference in frequency in relation to controls. Chronic kidney disease patients had statistically lower concentration of total proteins and albumin (p < 0.001), as well lower BMI values (p = 0.002). Despite this, no significant correlation of laboratory parameters with dyspeptic symptoms was found. Pathohistological examination indicated that the most common finding in hemodialysis patients was chronic active gastritis (58%), while chronic atrophic gastritis was significantly more common in dialytic patients (p = 0.032). Patients on hemodialysis had more frequently atrophy of corpus mucosa, which was positively related to dialysis duration (p = 0.001) and negatively related to pH values (p = 0.004) and bicarbonate concentration (p = 0.049). Helicobacter pylori was considerably more common in patients who underwent shorter time on hemodialysis (p < 0.001) and had higher values of bicarbonate (p = 0.037).ConclusionMaintenance hemodialysis patients are at risk for chronic gastric diseases that correlated with both dialysis vintage and duration.

The aim of this study was to analyze the prevalence of Helicobacter pylori infection and gastroduodenal lesions in Montenegrin patients with chronic kidney disease on hemodialysis. The study included 55 hemodialysis patients with dyspeptic symptoms and 50 control subjects with normal kidney function who had also dyspepsia. After dyspepsia assessment by an interview, all subjects underwent gastroduodenoscopy and histopathological analysis of biopsy specimens, taken from the corpus and antrum of the stomach. Helicobacter pylori was confirmed in 50.9% of corpus mucosa i.e. 60.6% of antrum mucosa of maintenance hemodialysis patients. There were no significantly differences in endoscopic findings of the stomach and bacterial presence between the two study groups of participants (p = 0.451), while duodenal lesions were prevalent in control subjects (p < 0.001). The atrophy of corpus mucosa was more common in hemodialysis patients (p = 0.007), especially in those who have been on hemodialysis for a longer time (p < 0.001) and had lower pH (p = 0.011). The prevalence of Helicobacter pylori infection shown an inverse relationship with dialysis duration. Contrary, a positive relationship between Helicobacter pylori and the concentration of bicarbonate was demonstrated (p = 0.031). The prevalence of Helicobacter pylori and atrophic mucosal changes in Montenegrin hemodialysis patients depends on dialysis duration and acid-base balance.